Archives of Iranian Medicine
Volume:21 Issue: 10, Oct 2018

  The aim of this study was to investigate the intra-familial transmission of chronic hepatitis B (CHB) in Golestan province, that has the highest prevalence of CHB in Iran. The Golestan Cohort Study (GCS) is a population-based prospective study of 50045 individuals, 40 years or older, initially set-up to study upper GI cancers in Northern Iran. In 2008, a baseline measurement of hepatitis B surface antigen (HBsAg) on the stored serum of all GCS participants identified 3505 HBsAg+ individuals. In 2011, we assessed HBV serological markers in 2590 initially HBsAg+ individuals and their first-degree relatives including spouses (1454) and children (3934). The median (IQR) age of spouses and children were 52 (12) and 25 (12) years respectively. Out of 5388 family members, 2393 (44.5%) had no HBV markers, indicating susceptibility to infection. Of these, 378 (15.8%) were fully-vaccinated children with no apparent response to primary immunization. HBsAg was positive in 2.2% (n = 33) of spouses and 8.2% (n = 325) of children (overall rate of 6.6%). HBcAb was positive in 761 (52.3%) and 914 (23%) spouses and children, respectively. The rate of spontaneous loss of HBsAg (HBsAg-, HBsAb+ and HbcAb+) was 41.3% and 13.9% in spouses and children, respectively. A higher rate of HBsAg+ children (10.2%) was found in families in which the mother was positive for HBsAg compared with families where the father was positive for HBsAg (6.3%) (P < 0.001). When both parents were positive for HBsAg, the rate of HBsAg positivity was high (23.5%, P < 0.001). Despite high virus exposure rates between spouses (52.6 %), the prevalence of HBsAg positivity among them was very low (2.3 %). Sexual and parent-to-child transmission are important routes of CHB spread in this population from northern Iran despite the fact that 24 years have passed since the beginning of hepatitis B vaccination in infants. Low percentage of HBsAg positivity in spouses is related to high HBsAg clearance rate among them

Most pregnancy-related complications are associated with increased risks of adverse outcomes for mother and her infant. Although, relations between diet and pregnancy’s complications indicate that there may be some benefits of nutritional factors to prevent such disorders, there are rare studies regarding the associations of dietary patterns and mentioned complications. So, the aim of the present study was to determine the relationship between dietary patterns and risk of pregnancy-related complications.

The current prospective observational study was based on the data collected from 812 pregnant women. Dietary data was collected using a validated semi-quantitative food frequency questionnaire.

Three major dietary patterns identified according to the results from the factor loading matrix were: (i) ‘western dietary pattern’; (ii) ‘traditional dietary pattern’; (iii) ‘healthy dietary pattern’. Overall, this study demonstrated a marginal significant inverse association between high adherence to healthy dietary pattern and chance of having pre-eclampsia. Also, a high chance of pre-eclampsia was observed among women with the most adherence to western dietary pattern.

We found that dietary patterns might be associated with the risk of pregnancy-related complications. Further studies are required to confirm these findings

Data on the effects of folic acid supplementation on clinical symptoms and metabolic profiles of patients with endometrial hyperplasia (EH) are limited. This investigation was performed to evaluate the effects of folic acid supplementation on clinical symptoms and metabolic status of patients with EH. This randomized, double-blind, placebo-controlled trial was conducted among 60 women diagnosed with EH. Diagnosis of EH was made based on biopsy results. Participants were randomly allocated to 2 groups to take 5 mg/d folic acid supplements (n = 30) or placebo (n = 30) for 12 weeks. After the 12-week intervention, folic acid supplementation significantly decreased fasting plasma glucose (β -3.99 mg/ dL; 95% CI, -7.39, -0.59; P = 0.02), serum insulin levels (β -2.82 µIU/mL; 95% CI, -4.86, -0.77; P = 0.008), homeostasis model assessment for insulin resistance (β -0.68; 95% CI, -1.20, -0.17; P = 0.009), triglycerides (β -16.47 mg/dL; 95% CI, -28.72, -4.22; P = 0.009) and very-low-density lipoprotein (VLDL) cholesterol (β -3.29 mg/dL; 95% CI, -5.74, -0.84; P = 0.009), and significantly increased the quantitative insulin sensitivity check index (β 0.01; 95% CI, 0.004, 0.03; P = 0.01) compared with the placebo. Additionally, folic acid intake resulted in a significant reduction in serum high sensitivity C-reactive protein (hs-CRP) (β -0.36 mg/L; 95% CI, -0.52, -0.21; P < 0.001) compared with the placebo. Folic acid supplementation did not affect other metabolic parameters. In conclusion, we found that folic acid administration for 12 weeks to subjects with EH improved glycemic control, triglycerides, VLDL-cholesterol and hs-CRP levels, but did not influence recurrence and other metabolic profiles

Obstructive sleep apnea (OSA) which is the most common sleep disorder breathing (SDB), imposes heavy costs on health and economy. The aim of this study was to provide models based on data mining approaches (C5.0 decision tree and logistic regression model [LRM]) and choose a top model for predicting OSA without polysomnography (PSG) devices that is a standard method for diagnosis of this disease, to identify patients with this syndrome payment. In this cross sectional study, data was extracted from the medical records of 333 patients with sleep disorders who were referred to sleep disorders research center of Kermanshah University of Medical Sciences during the years 2012–2016. All patients underwent one night PSG. A stepwise LRM was fitted and its performance was compared with C5.0 decision tree with use of the criteria of accuracy, sensitivity and specificity. For C5.0 decision tree, accuracy was obtained 0.757 with 95% confidence interval (0.661, 0.838), sensitivity was 0.66 and specificity was 0.809. For LRM, these items were obtained 0.737 (0.639, 0.820), 0.693 and 0.78 respectively. C5.0 decision tree showed better performance than LRM in diagnosis of OSA. So this model can be considered as an alternative approach for PSG

As a prevalent metabolic disease, diabetes has different side effects and causes a wide range of co morbidity with a high rate of mortality. There is a need for certain interventions to manage this disease. Iranians usually have three main meals a day. Considering the special needs of diabetic patients and the possibility of hypoglycemia between the main meals, it is essential for these patients to eat something as a snack. Considering these conditions and the society’s orientation towards modern technologies such as smart phones, designing mobile-based nutrition recommender systems can be helpful. The snack recommender system is a knowledge-based smart phone application. This study has focused on the development of a recommender system that combines artificial intelligence techniques and makes up a knowledge base according to the guidelines posed by the American Diabetes Association (ADA). The snack menu was recommended in accordance with the patient’s favorites and conditions. The accuracy of the recommended menu was assessed in 2 steps. First, it was compared with the diet prescribed by three nutrition specialists. In the second step, system’s suggested menu was evaluated by the data from 30 diabetic patients using a valid questionnaire. The results of evaluating the snack recommender system by nutritionists showed that this system is capable of recommending various snacks according to the season (accuracy of 100%) and personal interests (accuracy of 90%) to diabetic patients. According to health nutritionists, the snacks suggested by this system are matched with Iranian culture. Moreover, the results revealed that a higher body mass index (BMI) makes the recommender system less sensitive to personal interests to suggest what is basically beneficial for one’s health. This study was a pioneering research to develop a more comprehensive dietary recommender system for diabetic patients which includes main meals as well. Patients found the system useful and were satisfied with the application. This system is believed to be able to help diabetic patients to take more healthy diet which leads to a better lifestyle

Rabies, as the most important zoonotic disease, is transmitted through a bite or scratch by an infected domestic or wild carnivores and bats or contact of open wound with infected saliva. The fluorescent antibody test (FAT) is the "gold standard" diagnostic method for suspected brain samples. For close monitoring of unknown encephalitis, rabies surveillance, and also the limitations for post-mortem diagnosis of rabies in human and performing fast prophylactic measures for other individuals in contact with rabid patients, ante-mortem diagnosis based on molecular methods such as real-time polymerase chain reaction (PCR) seems to be more reliable. In this study, we detected 2 positive rabid cases using SYBR Green real-time PCR for the first time in Iran. In this study, 3 saliva samples at intervals up to 6 hours were collected from any of the nine suspected patients with nonspecific symptoms between March 2016 and March 2017. Total RNA extraction, cDNA synthesis and real-time PCR were performed along with confirmed negative and positive controls. Then, we tracked the patients for follow-up and understanding of their status. On brain samples of patients who died, FAT and MIT (mouse inoculation test) were performed to obtain definitive results. In this study, the patients were 4 females and 5 males, between 8 and 80 years old from different geographical areas of Iran. The ante-mortem saliva samples of 2 out of nine patients who died were positive by SYBR Green real-time PCR. Positive results of FAT test on these samples confirmed the presence of rabies virus infection in their brains and also the ante-mortem diagnosis results. The results of this study suggest that SYBR Green real-time PCR technique on saliva sample can be used as an applicable method for ante-mortem diagnosis of rabies to avoid infection of other people such as the treating medical staff or family members of the patient

In all organisms, transfer RNA (tRNA) molecules are required to undergo post-transcriptional modifications at different levels in order to convert into mature tRNAs. These modifications are critical for many aspects of tRNA function and structure, such as translational efficiency, flexibility, codon–anticodon interaction, stability, and fidelity. Up to now, over 100 modified nucleosides have been identified in tRNAs from all domains of life. Post-transcriptional modifications include different chemical processes such as methylation, deamination, or acetylation, with methylation reactions as the most common. tRNA methyltransferases are a family of enzymes involved in the post-transcriptional methylation of tRNA bases. Recent studies have reported different human diseases resulting from defects in tRNA methyltransferase activity, including cancer, diabetes and neurological disorders such as intellectual disability (ID). In this article, we focused on biological function and characterization of tRNA methyltransferases associated with ID in order to explain how functional disruption of tRNA methyltransferases could lead to ID phenotype.

The knowledge of medicine underwent a revolution in the Qajar period, especially during the reign of Naser al-Din Shah Qajar (1831–1896 AD). The dispatch of students to Europe, establishment of Dar ul-Funun, Hafez al-Seheh Assembly, and clinics, entrance of European teachers and physicians to Iran, approval of medical rules by the parliament, introduction of a new therapeutic style, and translation of medical textbooks into Persian were some of the changes that occurred during this period. As a result, modern medicine influenced the Iranian-Islamic traditional medicine. An educated Iranian physician, Mirza Ali Doctor Hamedani was one of the physicians of this period, who traveled to France, studied the European medicine and considerably contributed to the evolution of the modern medicine along the traditional medicine. The present manuscript describes the scientific personality and contributions of this physician to the science of medicine